Health: Mental Health Strategy

Lord Newton of Braintree Excerpts

Monday 14th February 2011 Lords Chamber

[Lord Newton of Braintree]

My Lords, I had been going to say, “Five minutes not long”—six minutes still not long—“will speak a little staccato”. First, I declare an interest as chair of Suffolk Mental Health Partnership NHS Trust. Secondly, I shall make no special pleading on behalf of that trust; the points that I want to make are general points. Thirdly, I congratulate the noble Baroness, Lady Murphy, who has done us a service by getting this debate on the Floor of the House at what I think was short notice. I shall listen with great interest to the Minister’s reply to the thoughtful and penetrating points that she made.

I have a brief confession. I put my name down to speak, given the short notice, at only three minutes to 12, and I was slightly taken aback to find that I was second in the debate. It is just as well that I did not spend the whole weekend writing this speech, because I would probably have had to cut it in half. It is probably a mercy to the House that I have to be brief.

To start with, I congratulate the Government on having produced this paper. The very fact that it is there and seeks to put mental health into the mainstream in a different way is worth while. One cannot quarrel with its objectives. The list of specific objectives or policies in chapter 5 is pretty well impeccable, especially when taken with what the Government are saying about dementia. It includes services for veterans and, as the noble Lord, Lord Patel, will have noticed, services for drug misusers and offenders, which has been one of the Cinderella areas. All the right noises are being made, and I have no problem with the strategy. My concern—and this is perhaps a rather blunter way of putting some of the points made by the noble Baroness—is whether we have the right mechanisms for delivering the strategy on the ground. This is especially so in a time of austerity, and bearing in mind the demands for considerable savings of up to about £20 billion over a relatively short period, which actually started under the previous Government and which are now having an effect throughout the service.

There are two points. First, to echo something that the noble Baroness said, there is a clear link here between the worries in the voluntary sector, the third sector or the civil society—whatever it is being called this week—and the pressures on local authorities. That sector provides a wide range of services helping and supporting people, in both the mental health and the learning disabilities areas, as well as those with multiple problems including drugs and alcohol. There is a lot of concern about their prospects. Secondly, and most importantly, there is a real tension between some of the things being said and the emphasis on having not ring-fencing but local decision-making. I understand the aim but, whatever is said in this document, mental health remains, as someone in Suffolk said to me, somewhat below the radar with regard to public demand and perception. As it happens, I have never chaired an acute trust; I have chaired a specialist trust and two mental health trusts, so I have not faced this dilemma. But I am pretty clear that if I was chair of an acute trust or a PCT concerned with services in an area and you had problems in mental health, accident and emergency and maternity, there would not be much doubt about which two out of the three would win. One paper will not change that area. In other words, even if mental health is declared not to be Cinderella it is a long way from being clear that it will feel like that on the ground.

If anybody wonders whether I am alone in that, I refer them to this week’s Health Service Journal, which I happened to be leafing through on the way in. Page 9 says:

“Adviser says he was sacked for therapy views”.

I do not know whether that is true but he was worried about whether there was enough for the new therapy services. That links with page 13, which says:

“‘New’ talk therapy cash to come from existing funds”.

Again, I know no more than I am reading but if I go on to page 14, I read about:

“‘Despair’ over mental health cuts”,

being proposed by PCTs in the West Midlands, so I am not unique in having this worry. There is some evidence that the worry is real. I simply hope that my noble friend will be able to say how this strategy will be translated into real action on the ground.